Page 389 - UK AirCrew Regulations (Consolidated) March 2022

Part MED - ANNEX IV - Medical

enable them to safely exercise the privileges of the licence shall be assessed as unfit.
However, where their functional use of the musculoskeletal system is satisfactory for the
safe exercise the privileges in respect of a certain aircraft type, which may be
demonstrated where necessary through a medical flight or a simulator flight test, the
applicant may be assessed as fit and their privileges shall be limited accordingly.
(c) In case of doubt arising in the context of the assessments referred to in points (a) and (b),
applicants for a class 1 medical certificate shall be referred to the medical assessor of the
CAA and applicants for a class 2 medical certificate shall be assessed in consultation with
the medical assessor of the CAA.
MED.B.050 AMC1 Musculoskeletal system
(a) Applicants with any significant sequelae from disease, injury or congenital abnormality
affecting the bones, joints, muscles or tendons with or without surgery requires full
evaluation prior to a fit assessment.
(b) Applicants with inflammatory, infiltrative, traumatic or degenerative disease of the
musculoskeletal system may be assessed as fit provided the condition is in remission or
is stable and the applicant is taking no disqualifying medication and has satisfactorily
completed a medical flight or simulator flight test.Appropriate limitation(s) may apply.
(c) Applicants with abnormal musculoskeletal system, including obesity, undertaking medical
fight or flight simulator testing should satisfactorily perform all tasks required for the type
of flight intended, including the emergency and evacuation procedures.
MED.B.050 AMC2 Musculoskeletal system
(a) Applicants with any significant sequelae from disease, injury or congenital abnormality
affecting the bones, joints, muscles or tendons with or without surgery should require full
evaluation prior to a fit assessment.
(b) Applicants with inflammatory, infiltrative, traumatic or degenerative disease of the
musculoskeletal system may be assessed as fit provided the condition is in remission or
is stable and the applicant is taking no disqualifying medication and has satisfactorily
completed a medical flight test. Appropriate limitation(s) may apply.
(c) Applicants with abnormal musculoskeletal system, including obesity, undertaking a
medical flight test should satisfactorily perform all tasks required for the type of flight
intended, including the emergency and evacuation procedures.
MED.B.055 Mental Health
(a) Comprehensive mental health assessment shall form part of the initial class 1 aero-
medical examination.
(b) Drugs and alcohol screening shall form part of the initial class 1 aero-medical
examination.
(c) Applicants with a mental or behavioural disorder due to use or misuse of alcohol or other
psychoactive substances shall be assessed as unfit pending recovery and freedom from
psychoactive substance use or misuse and subject to satisfactory psychiatric evaluation
after successful treatment.
(d) Applicants with a clinical diagnosis or documented medical history of any of the following
psychiatric conditions shall undergo satisfactory psychiatric evaluation before they may be
assessed as fit:
(1) mood disorder;
(2) neurotic disorder;
(3) personality disorder;
(4) mental or behavioural disorder;
(5) misuse of a psychoactive substance.
(e) Applicants with a documented medical history of a single or repeated acts of deliberate
self-harm or suicide attempt shall be assessed as unfit. However, they may be assessed
as fit after satisfactory psychiatric evaluation.
(f) Aero-medical assessment
(1) Applicants for a class 1 medical certificate with any of the conditions specified in
point (c), (d) or (e) shall be referred to the medical assessor of the CAA.
(2) The fitness of applicants for a class 2 medical certificate with any of the conditions
specified in point (c), (d) or (e) shall be assessed in consultation with the medical
assessor of the CAA.
(g) Applicants with a documented medical history or clinical diagnosis of schizophrenia,
schizotypal or delusional disorder shall be assessed as unfit.
MED.B.055 AMC1 Mental Health
(a) Mental health assessment as part of the initial class 1 aero-medical examination
(1) A comprehensive mental health assessment should be conducted and recorded
taking into account social, environmental and cultural contexts.
(2) The applicant's history and symptoms of disorders that might pose a threat to flight
safety should be identified and recorded.
(3) The mental health assessment should include assessment and documentation of:
(i) general attitudes to mental health, including understanding possible
indications of reduced mental health in themselves and others;
(ii) coping strategies under periods of psychological stress or pressure in the
past, including seeking advice from others;
(iii) childhood behavioural problems;
(iv) interpersonal and relationship issues;
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